Is preexisting patellofemoral pain a contraindication to harvesting the patellar tendon? The conventional wisdom is yes; it would not be a wise procedure in this situation. Rather, it is like hitting a sore thumb with a hammer! In the past, when chondromalacia was seen at the time of arthroscopy, the graft choice would be changed to hamstrings.
The harvesting of the central third of the patellar tendon in a small tendon is more theoretical than practical. The advice in a small patient with a tendon width of only 25 mm would be to take a narrower graft of 8 to 9 mm or use another graft source.
Shelbourne has reported that a bony ossicle from Osgoode-Schlatters disease is not a contraindication to harvest of the patellar tendon. Because the fragment usually lies within the bony tunnel, this bone may be incorporated into the tendon graft.
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